Upper extremity disorders: A literature review to determine work-relatedness

Vender, Michael I.; Kasdan, Morton L.; Truppa, Kellie L.

doi:10.1016/s0363-5023(05)80263-1

Cited by 76 publications

(27 citation statements)

References 52 publications

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“…Trained animals participated in the task less as time progressed, and after 12 weeks, their median nerves showed marked fibrosis and macrophage infiltration. While the relationship between work activities and cumulative trauma has been questioned, 25,43 our results provide clear evidence of a causal relationship between repetitive motion and CTS in an animal model.…”

Section: Conclusion and Clinical Considerationsmentioning

confidence: 50%

“…44 While epidemiological studies have identified a positive relationship between the intensity and duration of repetitive and forceful hand-intensive tasks and the prevelance and incidence of CTS, many questions remain concerning the causal effects of work in CTS. 25,43 For example, the precise dose-response relationship between exposure to individual or combinations of risk factors and CTS onset and severity is not known. The underlying pathophysiological mechanisms, particularly in the early, most preventable stages of work-related CTS are unclear.…”

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confidence: 99%

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Performance of a High-Repetition, High-Force Task Induces Carpal Tunnel Syndrome in Rats

Clark

Alshatti²,

Barr³

et al. 2004

J Orthop Sports Phys Ther

113

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Study Design: A randomized controlled prospective experimental study with some repeated measures. Objectives: To characterize behavioral, sensory, motor, and nerve conduction decrements, and histological changes in the median nerve in rats trained to perform a high-force repetitive task. Background: Understanding of work-related carpal tunnel syndrome is hampered by the lack of experimental studies of the causes and mechanisms of nerve compression induced by repetitive motion. Most animal models of nerve compression have not employed voluntary repetitive motion as the stimulus for pathophysiological changes. Methods and Measures: Thirty Sprague-Dawley rats served as controls for 1 or more studies. Ten rats were trained to pull on a bar with 60% maximum force 4 times per minute, 2 h/d, 3 d/wk for 12 weeks. Motor behavior and limb withdrawal threshold force were characterized weekly. Grip strength and median nerve conduction velocity were measured after 12 weeks. Median nerves were examined immunohistochemically for ED1-positive macrophages, collagen, and connective tissue growth factor. Results: Reach rate and duration of task performance declined over 12 weeks. Grip strength and nerve conduction velocity were significantly lower after 12 weeks than in controls. Limb withdrawal threshold increased between weeks 6 and 12. Median nerves at the level of the wrist showed increases in macrophages, collagen, and connective-tissue growth-factor-positive cells. These effects were seen in both the reach and nonreach limbs. Conclusions: This animal model exhibits all the features of human carpal tunnel syndrome, including impaired sensation, motor weakness, and decreased median nerve conduction velocity. It establishes a causal relationship between performance of a repetitive task and development of carpal tunnel syndrome.

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Section: Conclusion and Clinical Considerationsmentioning

confidence: 50%

mentioning

confidence: 99%

Performance of a High-Repetition, High-Force Task Induces Carpal Tunnel Syndrome in Rats

Clark

Alshatti²,

Barr³

et al. 2004

J Orthop Sports Phys Ther

113

View full text Add to dashboard Cite

show abstract

“…Many of these studies have attempted to assess the relationship between wrist/ hand exposures to physical load factors in the development of CTS. However, many of these earlier studies in the 1980s suffered from 2 main deficiencies, as outlined in previously published reviews: 8,9 1. Diagnosis of occupational CTS based on symptoms and physical examination alone.…”

Section: Epidemiological Studies Set the Stagementioning

confidence: 99%

Carpal Tunnel Syndrome As an Occupational Disease

Kao¹

2003

The Journal of the American Board of Family Medicine

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Background: Symptoms related to carpal tunnel syndrome (CTS) represent common patient complaints for many primary care physicians. However, there is a surprising lack of guidelines on diagnosing occupational CTS readily accessible to primary care physicians. This article aims to fill part of that void by reviewing historical aspects of occupational CTS, leading up to more current epidemiologic studies of the association of CTS with occupational ergonomic risk factors.Methods: The English medical literature was reviewed on the relationship between CTS and occupational ergonomic risk factors. Recent legislative initiatives are discussed. Guidelines of diagnosing and managing occupational CTS are outlined.Results: Many studies are divided regarding whether CTS is associated with highly repetitive/forceful/ vibration work. However, a subset of patients presenting with symptoms related to CTS probably has occupational CTS. These patients can be objectively diagnosed and successfully treated and are able to return to work.Conclusions: By being armed with knowledge regarding the background of CTS and by following simple diagnosis and treatment guidelines, the family practitioner should be able to manage many patients presenting with work-related CTS.

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“…Os estudos sobre os fatores de risco de STC apresentam várias falhas metodológicas, não havendo acordo sobre a validade das análises para firmar uma relação causal [24][25][26][27][28] .…”

Section: Stc E Trabalho Stc E Trabalho Stc E Trabalho Stc E Trabalho unclassified

Síndrome do túnel do carpo: controvérsias a respeito de diagnóstico clínico e eletrofisiológico e a relação com o trabalho

Oliveira

2000

Arq. Neuro-Psiquiatr.

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RESUMO -O diagnóstico de síndrome do túnel do carpo (STC) apresenta dificuldades porque dormência e formigamento nos membros superiores e alterações de condução nervosa no nervo mediano são comuns na população, havendo baixa concordância entre sintomas e alterações eletrofisiológicas. O diagnóstico de STC deve ser feito somente na presença de sintomas característicos acompanhados de alterações eletrofisiológicas significativas. Os casos duvidosos devem ser observados. A associação da STC com certas atividades é controversa.PALAVRAS-CHAVE: síndrome do túnel do carpo, exames eletrodiagnósticos, lesões por esforços repetitivos. Carpal tunnel syndrome: controversies regarding clinical and electrodiagnosis and its work-relatednessABSTRACT -The diagnosis of carpal tunnel syndrome (CTS) may be difficult because paresthesias and tingling in the upper limbs are commonly reported in the general population. These symptoms are poorly correlated with changes of nerve conduction studies of the median nerve. CTS should be diagnosed only when typical symptoms are associated with significant electrophysiological abnormalities. The association of CTS with work is highly controversial.KEY WORDS: carpal tunnel syndrome, electrodiagnostic tests, cummulative trauma disorders. Embora a síndrome do túnel do carpo (STC) seja comum, conhecida há mais de 100 anos 1 , frequentemente tratada cirurgicamente, causa importante de incapacidade para o trabalho e motivo de regulações extensas e dispendiosas do ambiente de trabalho 2,3 , ela é ainda cercada de controvérsias a respeito do seu diagnóstico e sua relação com o trabalho.O presente artigo é uma revisão crítica da literatura a respeito das controvérsias do seu diagnóstico e a relação com o trabalho, chamando a atenção para a complexidade do diagnóstico clínico e eletrofisiológico, geralmente apresentados como fatos bem estabelecidos e inquestionáveis. DIAGNÓSTICO DIAGNÓSTICO DIAGNÓSTICO DIAGNÓSTICO DIAGNÓSTICONão há critérios clínicos padronizados para o diagnóstico de STC 4,5 , não havendo consenso universal se o diagnóstico deve ser feito em bases clínicas ou eletrofisiológicas 6-9 . Uma reunião de 12 especialistas concluiu por consenso que a STC deve ser definida como síndrome eletroclínica 6 , O quadro clínico é caracterizado por parestesias (formigamento) progressivas na mão, no início noturnas e posteriormente com duração mais prolongada, que desaparecem com movimentos da mão. As parestesias são localizadas na palma da mão e dedos mas o paciente pode relatar sintomas dolorosos

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Upper extremity disorders: A literature review to determine work-relatedness

Cited by 76 publications

References 52 publications

Performance of a High-Repetition, High-Force Task Induces Carpal Tunnel Syndrome in Rats

Performance of a High-Repetition, High-Force Task Induces Carpal Tunnel Syndrome in Rats

Carpal Tunnel Syndrome As an Occupational Disease

Síndrome do túnel do carpo: controvérsias a respeito de diagnóstico clínico e eletrofisiológico e a relação com o trabalho

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